HomeMy WebLinkAbout02-0423
Estate of ,~,.qu' d ,to/?
also known as
PETITION FOR PROBATE and GRANT OF LETTERS
S A~(J k
No.
To:
21-02-423
Register oflillS for the .
County of I/m~pllJ..u d in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the ex~.p/x
in the last will of the above decedent, dated dJ e-; "'--.; ,
and codicil(s) dated
!2fceased.
Social Security No. eQ. t)Lj -6;. ~ ~ M 9'
named
,.~
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in C (/ mv6iY P //J.A/' <i
h last family or principal residence at .15tJ Clt: / L/ P e
County, Pennsylv;wia, with
~ci .L~itJL# ~A
- d.f n~ ,t</:lb.tJ~ ~
(list street, number and muncipality)
Decendent, then /7 rfl/ L ./..:j-, l-9c/t1 d ~,
at
Except as follows, d edent did n t marry, was not divorced and did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows: i.~ Vi-I v~~ ~ci
~ya ,!, ,-7 0 ~ .tl,-!J
$ t,~"trO
$
$
$ 9,1 , rr--O r p--r::J
. /
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters -t"eri /J@ e./l/"7,q JP V
(testamentary; administration c.I.a.; administration d. b.n.c.l.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF ClJ!1BERLAND j
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and truly administer the estate according to law.
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affirmed and
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No. 21-02-423
Estate of
SANDRA SHERK
, Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW APRIL 26. 2002 :l9._, in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated OCTOBER 3. 200 1
described therein be admitted to probate and filed of record as the last will of
SANDRA SHERK
TESTAMENTARY
JUDITH A WISMAN
and Letters
are hereby granted to
\ ~~
/??hi/(? ~hf~~J~.J~
. egister of Wills
FEES
Probate, Letters, Etc. .........
Short Certificates( )..........
If;t&welh~ion ................
JCP
$ 200.00
$ 1') . 00
$ 9..00
$ 5.00
TOTAL _ $ 229.00
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ATTORNEY (Sup. Ct. LD. No.)
ADDRESS
Filed
PHONE
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21-02-423
LAST WILL AND TESTAMENT
OF
SANDRA SHERK
I, Sandra Sherk of Enola, Cumberland County, Pennsylvania, being of sound
and disposing mind, hereby make, publish and declare this to be my Last Will and Testament
hereby revoking all former Wills and Codicils made by me.
ITEM I: I direct that all my legal debts and funeral expenses shall be paid from
the assets of my estate as soon as practicable after my decease.
ITEM II: I direct and bequeath all of my estate of every nature and wherever
situate to my sister, Judith A. Wisman, providing she shall survive me by thirty days.
ITEM III: In the event my sister predeceases me or dies on or before the
thirtieth day following my death, I devise and bequeath all of my estate of every nature and
wherever situate, in equal shares, to: Todd B. Wisman, Jeffrey M. Wisman, and Jamie L.
Daugherty, who survive me. If any of the above do not survive me, I give his or her share to
such person's issue, per stirpes, who survive me.
ITEM IV: I direct that all taxes that may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my
residuary estate as a part of the expense of the administration of my estate.
ITEM V: I appoint my sister, Judith A. Wisman, Executrix of this my Last
Will. Should she fail to survive me or is otherwise unwilling or unable to serve then I appoint
Todd B. Wisman, Jeffrey M. Wisman and Jamie L. Daugherty, as Co-Executors, of this my
Last Will.
ITEM VI: I direct that my Executrix or her successors shall not be required to
give bond for the faithful performance of their duties in any jurisdiction, and should,
notwithstanding this direction, a bond be required, I direct that a surety bond not be required.
IN WITNESS WHEREOF, I have hereunto set my hand this 3 r d. day of
,0 c-tobe.r
, 200 1.
if~cf~
SANDRA SHERK
- 2-
"
The preceding instrument, consisting of this and two other typewritten pages
identified by the signature of the Testatrix, SANDRA SHERK, was on the day and date thereof
signed, published and declared by SANDRA SHERK, the Testatrix therein named, as and for
her Last Will, in the presence of us, who, at her request, in her presence, and in the presence
of each other have subscribed our names as witnesses hereto.
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Name
Q30 Eo >>k ~ St.
Address
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Address
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Name
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Address
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COMMONWEALTH OF PENNSYLVANIA )
) ss:
COUNTY OF ~ a...u\J~U-( \ )
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We, c;j'l..viD R-IP
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and Jjl:Afvy oj). /5:JjII1l C
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, the
Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing
instrument, being fIrst duly sworn, do hereby declare to the undersigned authority that the
Testatrix signed and executed this instrument as her Last Will and Testament and that she had
signed willingly and that she executed it as her free and voluntary act for the purposes therein
expressed, in that each of the witnesses, in the presence and hearing of the Testatrix, signed
the Will as witnesses and to the best of their knowledge, the Testatrix was at the time eighteen
years of age or older, of sound mind and under no constraint or undue influence.
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SWORN and Subscribed to and
before me this 3, d day of
De;\co€.r ,2001.
f
C;tnolo..... 1A1~v
Notary Public
o NOTARIAL SEAL
L1N~A WITMER, Notary Public
Harrisburg, Dauphin County PA
My Commission Expires 03-20-2004
INRE:
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNA.
SANDRA SHERK
No. 2002-00423
Date of Death: April 15, 2002
CERTIFICATION OF NOTICE UNDER RULE 5.6(a)
To the Register:
I certify that notice of the beneficial interest required by Rule 5.6(a) ofthe
Orphans' Court Rules was served on or mailed to the following beneficiaries ofthe above-
captioned estate on May 14, 2002.
Name
Address
Judith A. Wisman
11 Randi Road, Enola, P A, 17025
Respectfully Submitted,
IRA H. WEINSTOCK, P.C.
800 North Second Street
Harrisburg, P A 17102
Phone: 717-238-1657
Dated: 05/14/02
By: q~::io~~ ~
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EXI11-96)
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
WEINSTOCK IRA H PC
SUITE 100
800 N SEOCND STREET
HARRISBURG, PA 17102
-------- fold
ESTATE INFORMATION: SSN: 204-28-2159
FILE NUMBER: 2102-0423
DECEDENT NAME: SHERK SANDRA
DATE OF PAYMENT: 01/22/2003
POSTMARK DATE: 01/21/2003
COUNTY: CUMBERLAND
DATE OF DEATH: 04/15/2002
NO. CD 002067
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $10,992.36
I
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I
TOTAL AMOUNT PAID:
REMARKS: JUDITH A WISMAN
C/O IRA H WEINSTOCK PC
CHECK# 4939
SEAL
INITIALS: JA
RECEIVED BY:
REGISTER OF WILLS
$10,992.36
DONNA M. OTTO
DEPUTY REGISTER OF WILLS
, .
REV-1500EX+t8-OO)
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REV-1500
INHERITANCE TAX RETURN
RESIDENT DECEDENT
COMMONWEALTH OF
PENNSYLVANIA
DEPARTMENT OF REVENUE
DEPT. 280601
HARRISBURG, PA 17128-0601
I-
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DECEDENT'S NAME (LAST. FIRST. AND MIDDLE INITIAL)
SHERK
DATE OF DEATH (MM-DD-Year)
SANDRA
DATE OF BIRTH IMM-DD-Vearj
J
04115/2002 02119/1937
(IF APPUCABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE INITIAL)
00 1. Original Retum
o 4. LimiledEstate
00 6. Decedent Died Testate (_"",oIWilI
o 9. Litigation Proceeds Received
o 2. Supp,mlOntal Retum
o 4a. Future Interest Compromise (datBoIdeaIh.. 12-12-82)
o 7. Decedenl Mailltained a living Trust__...,oITruot)
o 10. Spousal Poverty Credn 1""01_ """"'''.31-91 "" 1-1-95)
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THIS SECTION MUST BE COMPLETED. ALL
NAME
FRED H. WEGE JR.
FIRM NAME (~App<able)
WEGE ASSOCIATES
TELEPHONE NUMBER
717 558-8600
PONDENCE AND C TAX INFORMATION SHOULD BE DIRECTED TO:
COMPlETE MAILING ADDRESS
8150 DERRY ST., SUITE B
(:)
1-'-1D~S_
FIlE NUMBER
21-020423
"'COi:iNTY'"Cl5OE~---tiiiiER--
SOCIAL SECURITY NUMBER
204-28-2159
THIS RETURN IIlJST BE FILED IN DUPlICATE IlITH TNf
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
o 3. RemainderRetum (daI8cfdealtl priortl 12-13-82)
o 5. Federal Estate Tax Retum Required
.Q.. 8. Total Number of Safe Deposn Boxes
o 11.ElecliontotaxunderSec.9113(A)_hSohOI
1. Real Estate (Schedule A)
2. SlOdls and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or Sole-Proprietorship
4. Mortgages & Notes ReceNable (Schedule D)
5. Cash, Bank Deposils & Miscellaneous Personal Property
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
o Seoarate Billing Requested
7. Inter-VIVOS TransfelS & MisoeUaneous Non-Probate Properly (7)
(Schedule G or L)
HARRISBURG
87,191.35 i
.0.00
0.00
0.00
6,003.00
21,406.12) .
o.ool
X _(15)
X _(16)
91,603.01 X .12 (17) 10,992.36
X .15 (18)
(19) 10,992.36
(1)
(2)
(3)
(4)
(5)
8. Total Gross Assets (total Lines H)
9. Funeral Expenses & Administrative Costs (Schedule H) (9)
10. Debls of Deoedent. Mortgage L~bilnles, & Liens (Schedule i) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Vllue of Estate (Line B minus Line 11)
13. Charitable and Govemmental BequeslslSec 9113 Trusts for which an eleclion to tax has not been
made (Schedule J)
14. Net Vllue Subject to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amounl of Line 14 taxable lithe spousal tax
rale, ortransfelS under Sec. 9116 (1)(1.2)
16. AmounlofLine 14 taxable at lineal rate
17. Amounlof Line 14 taxable alsibling rate
18. Amounl of Line 14 taxable al col~teral rate
19. Till Due
20. 0
CHECK HERE IF YOU ARE REQUESTING A REFUND OF AN OVERPAYMENT
> > BE SURE TO ANSWER ALl QUESllONS ON REVERSe SIDE AND RECHECK MATH < <
PA 17111-5212
I
(8)
114,600.47
22,997.46
0.00
(11)
(12)
(13)
22,997.46
91,603.01
(14)
91,603.01
Decedent's ComDlete Address:
STREET ADDRESS 60 OLIVER ROAD
CITY ENOLA I STATE PA I ZIP 17025.2124
Tax Payments and Credits:
1. Tax Due (Page 1 Une 19)
2, CreditslPayments
A. Spousal Poverty Credit
8, Pnor Payments
C, Discount
(1)
10,992.36
TotaICredns(A+8+C) (2)
3. Interest/Penalty if applicable
0, Interest
E, Penalty
TotallnteresUPenalty (0 + E) (3)
4, If Une 2 is greater than Line 1 + Une 3, enterthe difference, This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4)
5, If Line 1 + Line 3 is greater than Line 2, enter the difference, This Is the TAX DUE. (5)
A, Enter the interest on the tax due, (5A)
8, Enter the total of Line 5 + 5A, This is the BALANCE DUE. (58)
Make Check Payable to: REGISTER OF WILLS, AGENT
10,992.36
10,992.36
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN .X. IN THE APPROPRIATE BLOCKS
1, Did decedent make a transfer and: Yes No
a, retain the use or Inoorne of the property transferred; """,,,,,.,.,,,,,,,,,,,,,.,,,,,,,,,,,,,,,,,,,,,""''''',,.,,,.,,''''',,. 0 00
b, retain the nghtto designate who shall use the property transferred or ns income; """""".""""""""",,""'" 0 00
c, retain a reversionary interest; or """"""""""""""""""""""""""""""""""",,.,,""""""""""""'" 0 00
d, receive the promise for loe of either payments, benefits or care? ."."."""""""""""""""""",,"""""""" 0 00
2, If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiYlng adequate consideration?",.,,,............................,,..................,,,,,.,..,,,,,,,,,,, "',""""""",' 0 00
3, Did decedent own an 'in t",slfo~ or payable upon death book account or security at his or her death? ..............." 0 00
4, Old decedent own an Indiyidual Retirement Aocount, annuity, or other non-probate property which
contains a beneficiary deaignation? ...........""..', """""""""""""",..""..,.,.,..........................',.........."" 00 0
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES, YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
Underpenaties of perjury, 1 declare ltIat I have examined this retum, includi~ acccMT'lP'fl)'ing schedules and s1aIements. andtl the bestofmy knowledge and belief, it is true, correcl
and compIele.
Declaration of preparer othef than the personal representative is based on all Information of which prepcrer has Cfly knowledge.
DATE
/d/,cP7-o,{}.
,
PA 17025.1822
DATE
12117/02
PA 17111-5212
'frTU~: D~:4(~:d::~::.IN;;2TURN
~RANDIROAD ~
ENOLA
SIGNATURE OF PREPARER 0
~
ADDRESS 8150 DERRY S
HARRISBURG
For dates of death on or after July 1, 1994 and before January 1,1995, the tax rate imposed on the net yalue of transfers to or for the use of the surviving spouse is 3%
[72 P,S, ~116 (a) (1,1) (i)).
For dates of death on or after January 1,1995, the tax rate Imposed on the net yalue of transfers to or for the use of the surviving spouse is 0% [72 P,S, ~9116 (a) (1.1) (Ii)),
The statute does not exemDt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets and filing a tax return are still applicable even 0
the surviving spouse is the only beneficiary,
For dates of death on or after July 1, 2000:
The tax rate imposed on the net yalue of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural parerrt, an adoptive parent.
or a stepparent of the child is 0% [72 P,S, ~9116(aX1,2)],
The tax rate imposed on the net yalue of transfers to or for the use of the decedent's lineal beneficianes is 4,5%, except as noted in 72 P,S, ~9116(1,2) [72 P,S, ~9116(aX1)).
The tax rate imposed on the net yalue of transfers to or for the use of the decedent's siblings is 12% [72 P,S, ~9116(a)(1.3)), A sibling is defined, under Section 9102, as an
indiyidual who has at least one parent in common with the decedent, whether by blood or adoption,
REV,...x'I"" .
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
SCHEDULE A
REAL ESTATE
ESTATE OF FILE NUMBER
SHERK SANDRA J 21 02 0423
AI INI property owned 101ely or II I Isnlnt In common must be "POrted 1\ IIlr morUt VlIue. Fair lIIllI1<et value is defined as 1I1e price at which properly wookJ be exchangsd
between a willing buyer and a Willing seller, neither being compelled to buy or sell, both having reasoneble knowledge of 1I1e relevant fads. Rul property which Is jolntly-owned wIlh
right of
IU",NolShl" must be disclosed on Schedule F.
ITEM
NUMBER
1.
2
3
4
5
DESCRIPTION
VALUE AT DATE
OF DEATH
89,900.00
,U , t'RICF
60 OLIVER ROAD
ENOLA, PA 17025-2124
SELLER ASSIST PER AGREEMENT OF SALE
60 OLIVER ROAD
ENOLA, PA 17025-2124
COUNTY TAX ADJUSTMENT
60 OLIVER ROAD
ENOLA, PA 17025-2124
SCHOOL TAX ADJUSTMENT
60 OLIVER ROAD
ENOLA, PA 17025-2124
SEWERlTRASH ADJUSTMENT
60 OLIVER ROAD
ENOLA, PA 17025-2124
-3,700.00
94.28
866.55
30.52
I
TOTAL (Also enter 00 line 1, Recapttulation) $
(If more space is needed, insert additional sheets of the same size)
87.191.35
"""",,"""".
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
R I T
ESTATE OF
SHERK SANDRA J
All property jolntly-owned with right of Iurvivorshlp mUlt bI dilclolld on Schldule F.
SCHEDULE B
STOCKS & BONDS
FILE NUMBER
21 02
0423
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
0:00
..."'....,
TOTAL (Also enter on line 2. Recapitulation) $
(It more space;s needed, Insert additional sheets of the same size)
0.00
REV"''''''''.''.
COMMONWEALTH OF PENNSVLVANIA
INHERITANCE TAX RETURN
R I T
ESTATE OF
SHERK SANDRA
SCHEDULE C
CLOSELY-HELD CORPORATION,
PARTNERSHIP or SOLE-PROPRIETORSHIP
J
FILE NUMBER
21 02
0423
Schedukl C-1 or C-2 (Induding all suppol1ing informa1ion) must be attached for each cIose~-heId corporation/partnership interest of the decedent, oIt1er than a sole-proprie\orship.
See inslnJcIions for the supporting information to be submitted for soIe-proplieforships.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
0.00
NON!:
TOTAL (Also enter 00 line 3, Recapnulation) $
(If more space is needed, insert additional sheets of the same size)
0.00
REIf'l50TEX.(1.sT)
*'
SCHEDULE D
MORTGAGES & NOTES
RECEIVABLE
COMMONWEALTH OF PENNSYLVANIA
INHE~TANCE TAX RETU~
RESIDENT DECEDENT
ESTATE OF
SHERK
SANDRA
J
FILE NUMBER
21 02
0423
AU property jolntly-o...ed with the right ohurvlvo"hlp must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
VALUE AT DATE
OF DEATH
0.00
TOTAL (Also enteron line 4, Recapitulation) $
(If more space is needed, insert addnional sheets of the same size)
0.00
REV'''''''''''',*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE E
CASH, BANK DEPOSITS, & MISC.
PERSONAL PROPERTY
ESTATE OF
SHERK
SANDRA
J
FILE NUMBER
21 02
0423
Indude the proceeds of litigation and the date the proceeds were received by the estate. All property jolntly-owned with the right of survivorship must be disclosed on Schedule F.
ITEM
NUMBER
1.
DESCRIPTION
2
ERIE INSURANCE AUTO POLICY REFUND
103.00
TOTAL (Also enter on line 5, Recapitulation) $
(~more spaoe is needed, insert additional sheets of the same size)
6 003.00
REV"""EX'''''"*
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE F
JOINTLY-OWNED PROPERTY
ESTATE OF
SHERK
SANDRA
J
FILE NUMBER
21 02
0423
K an asset was made joint _in one year of the _.nrs dele of death, l must be reported on Schedule G.
SURVIVING JOINT TENANT(S) NAME
AODRESS
RELATIONSHIP TO DECEDENT
A.
ENOLA, PA 17025-1822
B
c
JOINTLY-OWNEO PROPERTY:
LETTER DATE OESCRPTION OF PROPERTY lIOF OATE OF DEATH
ITEM FOR JOINT MADE Include name offinlllCiaI institution 8ld balk account number Of similar identifying nulTtler. Attach DATE OF DEATH DECClS VALUE OF
NUMBER TENANT JOINT deed for joinUy-heId real estate. VALUE OF ASSET INTEREST DECEDENT'S INTEREST
1. A. 10/16/01 PNC BANK, NA #5000821266 SAVINGS 15,976.80 50. 7,988.40
ENOLA, PA
2 A 10/16/01 PNC BANK, NA #5140057351 CHECKING 26,835.43 50. 13,417.72
ENOLA, PA
TOTAL (Also enter on line 6, Recapfiulation) $ 21.406.12
(If more space is needed, insert additional sheets of the same size)
, .
REV","""""".
COMMONWEALTH OF PENNSYLVANIA
INHEroTANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE G
INTER.VIVOS TRANSFERS &
MISC. NON.PROBATE PROPERTY
ESTATE OF
SHERK
SANDRA
J
FILE NUMBER
21 02
0423
Th~sc!ledule must be completed and filed Wthe answer to any of questions 1 through 4 on the rev.... skHl of the REV-l500 COVER SHEET ~ yes.
DESCRIPTION OF PROPERTY %OF
ITEM INQ.Uoe THE NAME OF THE TRANSfEREE, THEIR R8.ATlONSHPTO cecer.ENT ~D THE DATE OF TRANSfER. DATE OF DEATH DECD'S EXCLUSION TAXABLE VALUE
NUMBER ATTACH ACOPVOFTHE OEED FCfl REAL ESTJ\TE. VALUE OF ASSET INTEREST llFAPP..1CAR.E)
1. 0.00
TOTAL (Also enter on line 7, Recapitulation) S 0.00
(If more space is needed, insert additional sheets of the same size)
REV.""".'''".
COMMONWEAlTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
SCHEDULE H
FUNERAL EXPENSES &
ADMINISTRATIVE COSTS
ESTATE OF
SHERK
SANDRA
J
FILE NUMBER
21 02
0423
Debts of decedent must be reported on Schedule I.
ITEM
NUMBER DESCRIPTION AMOUNT
A FUN~RAL EXPEN8E~
1- PA THEM EFUNERALHOME 7,710.00
2 ROLLING GREEN MEMORIAL PARK 870.00
3 CUMBERLAND LAW JOURNAL 75.00
4 CARLISLE SENTINAL 90.59
8. ADMINISTRATIVE COSTS:
1. Personal Representative's Commissions
Name of PelSOnal Represenfative (s)
Sodal Security Numbe~s) I EIN Number of PolSOnal Represenfative(s)
Street Address
City Sfate Zip
Yea~s) Commission Paid:
2. AttomeyFees JASON M. WEINSTOCK, HARRISBURG, PA 4,830.00
3. Fami~ Exemption: (If deoedenfs address is not tl1e same as claimanfs, attach explanation)
Claimant
Street Address
City Sfate Zip
Relationship of Claimant to Decedent
4. ProbeteFees CUMBERLAND COUNTY REGISTER OF WILLS 238.00
CARLISLE, PA 17013
5. AccountantsFees WEGE ASSOCIATES 1,000.00
8150 DERRY ST., SUITE B, HARRISBURG, PA
6. Tax Retum Prepare!s Fees
7. REAL ESTATE SETTLEMENT SHEET COSTS 7,661.18
8 EXPENSE TO MAINTAIN HOME UNTIL SOLD
ELECTRIC 40.02
WATER 31.42
SEWER 87.75
GAS 130.03
PHONE 29.41
CABLE 40.06
HOME INSURANCE (NET) 47.00
9 MEDICAU DR. CONROY 100.00
10 FAMILY SETTLEMENT FEE/REGISTER OF WILLS 17.00
TOTAL (Also enter on line 9, Recapitulation) $ 22997.46
(If more space is needed, insert additional sheets of tlle same size)
""."'''''.,,.''.
COMMONwEALTH OF PENNSYlVAMA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SHERK SANDRA
SCHEDULE I
DEBTS OF DECEDENT,
MORTGAGE LIABILITIES & LIENS
J
FILE NUMBER
21 02
0423
Include unrelmbursed medical expenses.
ITEM
NUMBER
DESCRIPTION
AMOUNT
1.
NONE
0.00
TOTAL (Also enter 00 line 10, Recapnulatioo) $
(~more space is needed, insert additional sheets of the same size)
0.00
REV.,5,3.X.'.
COMMONWEAL Tli OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
NUMBER
I.
SCHEDULE J
BENEFICIARIES
'A .I
1.
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [include outright spousal distributions. and lransfers under
Sec. 9116(0) (1.2))
JUDITH A WISMAN
11 RAND' ROAD
ENOLA, PA 17025-1822
FILE NUMBER
'1 n?
RELATIONSHIP TO DECEDENT
Do Not Ult Trustee(l)
SISTER
nA""
AMOUNT OR SHARE
OF ESTATE
100%
ENTER DOLLAR AMOUNTS FOR DISTRIBUTIONS SHOWN ABOVE ON LINES 15 THROUGH 18, AS APPROPRIATE, ON REV-l500 COVER SHEET
II. NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SECTION 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
1.
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
1.
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRIBUTIONS ON LINE 13 OF REV-l500 COVER SHEET $
(If more space is needed, insert additional sheets of tlle same size)
WHEREAS, on the 26th
dated October 3rd 2001
was admitted to probate as the last will of SHERK SANDRA
(LA,:)l/ .t'lK:::>'l, lVllULJL1::;
Register of Wills of CUMBERLA.'JC Couety, ?ecmsyl vania
Certificate of Grant of Le~~ers
No. 2002-00423 PA No. 21-02-0423
ESTATE OF SHERK SANDRA
(LAo'l, 1'1"01, YIllJlJLlo)
Late of
EAST PENNSBORO TOWNSHIP
~UM~~KLN~U LUUN~~1
Deceased
Social
day
Security
of April
2002 an instrument
No.
204-28-2159
late of EAST PENNSBORO TOWNSHIP CUMBERLAND Coum:y, W!10 died on tr.e
15th day of April 2002 and,
WHEREAS, a true copy of the will as probated is annexed hereto.
THEREFORE, I, MARY C. LEWIS , Register of Will.s in and for
the County of CUMBERLAND in the Commonwealth of Pennsylvania, hereby certify
that I have this day granted Letters TESTAMENTARY
to WISMAN JUDITH A
who has duly qualified as Executor (rix)
and has agreed to administer the estate according to law, all of which fully
appears of record in my Office at CUMBERLAND CO'wqTY COURT HOUSE,
CARLISLE, PENNSYLVANIA.
IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal
of my Office the 26th day of April 2002.
~;r]J(/ Y (!:yti~/L'.~NU// !(.t-,ffiuA(./
y ~ eglSG r of II s /
,
**NOTE** ALL NAMES ABOVE APPEAR (LAST, FIRST, MIDDLE)
21-02-423
LAST WILL AND TESTAMENT
OF
SANDRA SHERK
I, Sandra Sherk of EnoIa, Cumberland County, Pennsylvania, being of sound
and disposing mind, hereby make, publish and declare this [0 be my Last Will and Testament
hereby revoking all former Wills and Codicils made by me.
ITEM I: I direct that all my legal debts and funeral expenses shall be paid from
the assets of my estate as soon as practicable after my decease.
ITEM II: I direct and bequeath all of my estate of every nature and wherever
situate to my sister, Judith A. Wisman, providing she shall survive me by thirty days.
ITEM III: In the event my sister predeceases me or dies on or before the
thirtieth day following my death, I devise and bequeath all of my estate of every nature and
wherever situate, in equal shares, to: Todd B. Wisman, Jeffrey M. Wisman, and Jamie L.
Daugherty, who survive me. If any of the above do not survive me, I give his or her share to
such person's issue, per stirpes, who survive me.
ITEM IV: I direct that all taxes tha~ may be assessed in consequence of my
death, of whatever nature and by whatever jurisdiction imposed, shall be paid from my
residuary estate as a part of the expense of the administration of my estate.
ITEM V: I appoint my sister, Judith A. Wisman, Executrix of this my Last
Will. Should she fail to survive me or is otherwise unwilling or unable to serve then I appoint
Todd B. Wisman, Jeffrey M. Wisman and Jamie L. Da.JJgherty, as Co-Executors, of this my
Last Will.
ITEM VI: I direct that my Executrix or her successors shall not be required to
give bond for the faithful performance of their duties in any jurisdiction, and should,
notwithstanding this direction, a bond be required, I direct that a surety bond not be required.
IN WITNESS WHEREOF, I have hereunto sel my hand this 3. d day of
Oc-tobe.r
, 200 1.
cJ~c:ru
SANDRA SHERK
- 2-
The preceding instrument, consisting of this and two other typewritten pages
identified by the signature of the Testatrix, SANDRA SHERK, was on the day and date thereof
signed, published and declared by SANDRA SHERK, the Testatrix therein named, as and for
her Last Will, in the presence of us, who, at her request, in her presence, and in the presence
of each other have subscribed our names as witnesses hereto.
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Address
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"
COMMONWEALTH OF PENNSYLVANIA)
) ss:
COUNTY OF ..:u a...u\Jh.';"{ \ )
----
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We, J'f'j,.IJJD R...J7
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and 'vi EN'i>'j j)i3:J il,,!! C
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, the
Testatrix and the witnesses respectively, whose names are signed to the attached or foregoing
instrument, being first duly sworn, do hereby declare to the undersigned authority that the
Testatrix signed and executed this instrument as her Last Will and Testament and that she had
signed willingly and that she executed it as her free and voluntary act for the purposes therein
expressed, in that each of the witnesses, in the presence and hearing of the Testatrix, signed
the Will as witnesses and to the best of their knowledge, the Testatrix was at the time eighteen
years of age or older, of sound mind and under no constraint or undue influence.
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SWORN and Subscribed to and
before me this 3r d day of
_ Dc:..+Cbe r , 2001.
J
2J:;.r.pc... (I\)~v
Notary Public
NOTARIAL SEAL
liNDA WiTMER, Notary Public
Harrisburg, Dauphin County PA
My Commission Expires 03-20-2004
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INRE:
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNA.
SANDRA SHERK,
Deceased
No. 21-020423
Date of Death: April 15, 2002
STATUS REPORT UNDER RULE 6.12
Pursuant to Rule 6.12 of the Supreme Court Orphans' Court Rules, I report the following
with respect to completion of the administration of the above-captioned estate:
1. State whether administration of the estate is complete: Yes
2. If the answer is No, state when the personal representative reasonably believes
that the administration will be complete:
3. If the answer to No.1 is yes, state the following:
A. Did the personal representative file a final account with the court? No
B. The separate Orphans' Court No. (if any) for the personal representative's
account is: 21-020423
C. Did the personal representative state an account informally to the parties
in interest? Yes. See Family Settlement and Final Release attached
hereto.
D. Copies of receipts, releases, joinders and approvals of formal or informal
accounts may be filed with the Clerk of the Orphans' and may be attached
to this report.
Date: / /~t/03
, ,
, i
/"")
, _.~)l-'"l .~.~.
-
;/ (01)7:;.
800 North Second Street
Harrisburg, P A 17102
717-238-1657
Capacity:
_ Personal Representative
~ Counsel for Personal Representative
//}-60 -3
'v BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z8D6Dl
HARRISBURG, PA 171Z8-D6Dl
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOTICE OF INHERITANCE TAX
APPRAISEHENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSHENT OF TAX
FRED
WEGE
8150
HBG
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
03-17-2003
SHERK
04-15-2002
21 02-0423
CUMBERLAND
101
H WEGE JR
ASSOCIATES
DERRY ST STE B
PA
'*
REV-1541 EX RFP 101-D31
SANDRA
J
Allount Rellitted
17111
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
CUT ALONG THIS LINE ~ RETAIN LOWER PORTION FOR YOUR RECORDS ~
REV =iS4-j-i3f-AFP--loY:03Y-NOYici--OF-YNHiifiTANCE-YA'X-'A-pPRjrisiMENT~--AL1-owAircE-(fR------------ -----
DISALLOWANCE OF DEDUCTIONS AND ASSESSMENT OF TAX
ESTATE OF SHERK SANDRA J FILE NO. 21 02-0423 ACN 101 DATE 03-17-2003
TAX RETURN WAS: (X) ACCEPTED AS FILED
) CHANGED
I~ an assessment was issued previously, lines 14, 15 and/or 16, 17, 18 and 19 will
re~lect ~igures that include the total o~ ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Allount of Line 14 at Spousal rate (15)
16. Allount of Line 14 taxable at Lineal/Class A rate (16)
17. Allount of Line 14 at Sibling rate (17)
18. Allount of Line 14 taxable at Collateral/Class B rate (18)
19. Principal Tax Due
TAX CREDITS:
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A)
2. Stocks and Bonds (Schedule B)
3. Closely Held Stock/Partnership Interest (Schedule C)
4. Hortgages/Notes Receivable (Schedule D)
S. Cash/Bank Deposits/Hisc. Personal Property (Schedule E)
6. Jointly Owned Property (Schedule F)
7. Transfers (Schedule G)
8. Total Assets
(1)
(2)
(3)
(4)
(5)
(6)
(7)
87.191.35
.00
.00
.00
6.003.00
21. 406.12
.00
(8)
APPROVED DEDUCTIONS AND EXEMPTIONS:
9. Funeral Expenses/Adll. Costs/Hisc. Expenses (Schedule H)
10. Debts/Hortgage Liabilities/Liens (Schedule I)
11. Total Deductions
12. Net Value of Tax Return
13. Charitable/Governllental Bequests; Non-elected 9113 Trusts (Schedule J)
14. Net Value of Estate Subject to Tax
(9)
(10)
22,997.46
.00
NOTE:
.00 X
.00 X
91,603.01 X
.00 X
NOTE: To insure proper
credit to your account,
subllit the upper portion
of this forll with your
tax paYllent.
114,600.47
(11)
(12)
(13)
(14)
22.997 46
91,603.01
.00
91,603.01
00 =
045 =
12 =
15 =
.00
.00
10,992.36
.00
10,992.36
(19)=
,,~v~.. . (+J AHOUNT PAID
DATE NUHBER INTEREST/PEN PAID (-)
01-21-2003 CD002067 .00 10,992.36
BALANCE OF UNPAID INTEREST/PENALTY AS OF 01-22-2003 TOTAL TAX CREDIT 10,992.36
BALANCE OF TAX DUE .00
INTEREST AND PEN. 9.04
TOTAL DUE 9.04
. IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
IF TOTAL DUE IS LESS THAN $1, NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR), YOU HAY BE DUE
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)
FAMILY SETTLEMENT AND FINAL RELEASE
IN
ESTATE OF SANDRA SHERK
KNOW ALL MEN BY THESE PRESENTS:
WHEREAS, Sandra Sherk, late of East Pennsboro Township, Cumberland
County, Pennsylvania died testate on April 15, 2002.
WHEREAS, Judith A. Wisman applied for Letters Testamentary, and was
granted the Letters on April 26, 2002;
WHEREAS, Letters Testamentary, on the estate of the said decedent were duly
issued by the Register of Wills of Cumberland County, to the said Executrix, hereinafter called
Executrix;
WHEREAS, the Executrix did advertise the grant of letters and obtained proofs
of publication which are attached hereto as Exhibit "A";
WHEREAS, the said Executrix has gathered the assets of the estate of the said
decedent and the assets consist of both real property and personal property, to a total value of
$114,600.47;
WHEREAS, the following debts, administrative costs, and deductions, including
the payment of inheritance tax in the said estate, amount to $33,989.82:
Parthemore Funeral Home $ 7,710.00
Rolling Green Memorial Park $ 870.00
Cumberland Law Journal $ 75.00
Carlisle Sentinel $ 90.59
Cumberland County Register
of Wills $ 238.00
Real Estate Settlement Costs $ 7,661.18
Electric $ 40.02
Water $ 31.42
..
Sewer $ 87.75
Gas $ 130.03
Phone $ 29.41
Cable $ 40.06
Home Insurance $ 47.00
Dr. Conroy $ 100.00
Wege Associates (CPA) $ 1,000.00
Ira H. Weinstock, P.c. $ 4,830.00
Inheritance Tax $ 10,992.36
Register of Wills (Family
Settlement) $ 17.00
Total $ 33,989.82
WHEREAS, the balance for distribution has been reduced to cash and has been
distributed as herein indicated in accordance with the terms of this Family Settlement and Final
Release.
NOW, THEREFORE, KNOW YE, that I, Judith A. Wisman, being the heir of
the said decedent, and being that person being entitled to inherent, do hereby, acknowledge that I
have this day had and received from the aforesaid personal representative, full satisfaction and
payment of all sums or sums of money, which amount I have received this day, and which
amount is in the amount set opposite my respective names in the Table and Schedule of
Distribution in said statement attached hereto and marked Exhibit "B";
AND, I do hereby stipulate that in order to avoid the expense and time involved in
the filing of a formal account and schedule of distribution, I agree that no account is necessary
and I do hereby agree that I do consent to distribution being made without the filing of an
account and schedule of distribution, the same to be with the same force and effect as if it had
been filed and confirmed by the Register of Wills, Cumberland County.
THEREFORE, I do hereby remise, release, quitclaim and forever discharge the
said Executrix, Judith A. Wisman, heirs, executors, and administrators and assigns, of and from
the said estate and from all actions, suits, payments, accounts, reckonings, claims and demands
whatsoever for or by reason thereof, or for any other use, matter, cause or thing whatsoever
touching upon the estate of the said decedent, and I do further hereby covenant and agree that
should any liability come due to the estate of the said decedent after the signing of this
agreement, I do hereby covenant and agree that I will contribute my share of the estate after the
signing, sealing and delivery of this family settlement agreement and final release.
IN WITNESS WHEREOF, I have hereunto set my hand and seal on the date set
forth below.
WITNESSES:
~ In. C~
/~~/;J ~
Judith A. Wisman
STATE OF PENNSYLVANIA
COUNTY OF Cu. M be..r L f\ N &.
)
) ss:
)
On this, the ~day of
TI\Nu..~ ri
,2003, before me, a Notary
Public, the undersigned officer, personally appeared Judith A. Wisman, to be the person whose
name is subscribed to the within instrument, and acknowledged that she executed the same for
the purpose therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
--1kL 1Il. C~
Notary Public
I~l ()3
I NOTARIAL SEAL
HELEN M. GRIFFITH, Nntary Public
I East Pennsbofo Twp. Cumberland Co.
J. MyCommlssiOfl~[es ~!~_~
PROOF OF PUBLICATION
State of Pennsylvania,
County of Cumberland.
Lori Saylor, Classified Advertising Manager of THE SENTINEL,
of the County and State aforesaid, being duly sworn, deposes and says that THE SENTINEL, a newspaper of
general circulation in the Borough of Carlisle, County and State aforesaid, was established December 13th,
1881, since which date THE SENTINEL has been regularly issued in said County, and that the printed notice
or publication attached hereto is exactly the same as was printed and published in the regular editions and
issues of THE SENTINEL on the following dates, viz
Copy of Notice of Publication
" NO'ttce
LETTERS T AMENTA-
RVlITth6
SANDRA !;!ite ,
of East Pennsboro
Township, C
Cumberland s-
nia, deCe , avi!1g
been ranted to Jlfdlth
A. I persons
i el!,la~
are make
imm
;mil th
or deman t
the same without d.y
to:
May 16, 23 & 30, 2002
Affiant further deposes that he is not interested in
the subject matter of the aforesaid notice or
advertisement, and that all allegations in the
foregoing statement as to time, place and character
of publication are true.
Judith A. Wisman,
Executrix
11 ~ndL69ad
tnolll,PA 1 'f0J?5
I :or to:
, Jason M. Wein$tO~k,
EsqUire
, 800 North Second Street
I Hafrisbiltg, PA 171 O?
~ ~t>L
May 31,2002
Sworn to and subscribed before me this 31 st
day of May , 2002.
0!u.clLv/ O. ~/tUVJ
Notary Public
My commission expires:
NOT ARIAL SEAL
SHIRLEY O. DURNIN, Notary Public
Carlisle Bora., Cumberland County
Commission Ex 'res Au . 9, 2003
EXHIBIT
"An
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approved May 16, 1929), P. L.1784
STATE OF PENNSYLVANIA:
ss.
COUNTY OF CUMBERLAND :
Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Journal, of the County
and State aforesaid, being duly sworn, according to law, deposes and says that the Cumberland
Law Journal, a legal periodical published in the Borough of Carlisle in the County and State
aforesaid, was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues ofthe said Cumberland Law
Journal on the following dates,
VIZ:
MAY 24, 31, JUNE 7, 2002
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Journal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication are true.
~
R ger M. Morgenthal, EdItor
---.
Sherk, Sandra. dec'd.
Late of East Pennsboro Town-
ship.
Executrix: Judith A. Wisman. 11
Randi Road, Enola, PA 17025.
Attorney: Jason M. Weinstock,
Esquire. 800 North Second
Street. Harrisburg, PA 17102.
SWORN TO AND SUBSCRIBED before me this
7 day of JUNE. 2002
NOTARIAL SEAl
LOIS E. SNYDER, ~ PublIc
CarflsIe Bora. Cumberiand County
My Commissbl ExpiI1I Man:h 5, 2005
Name of Relative
1. Judith A. Wisman
SCHEDULE OF DISTRIBUTION
Share of Estate
100%
EXHIBIT
"B"
I~~-'---"-"'-'----'-""-' --_.._-~-----
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPT. 280601
HARRISBURG, PA 17128-0601
REV-1162 EX(11-961
RECEIVED FROM:
PENNSYLVANIA
INHERITANCE AND ESTATE TAX
OFFICIAL RECEIPT
WEINSTOCK JASON M ESQUIRE
800 NORTH SECOND STREET
HARRISBURG, PA 17102
nnnn fold
ESTATE INFORMATION: SSN: 204-28-2159
FILE NUMBER: 2102-0423
DECEDENT NAME: SHERK SANDRA
DA TE OF PAYMENT: 01/05/2006
POSTMARK DATE: 01/05/2006
COUNTY: CUMBERLAND
DATE OF DEATH: 04/15/2002
NO. CD 006178
ACN
ASSESSMENT
CONTROL
NUMBER
AMOUNT
101 I $9.04
I
I
I
I
I
I
I
I
TOTAL AMOUNT PAID:
$9.04
REMARKS:
MIDSTATE ABSTRACT
CHECK# 116553
SEAL
INITIALS: RSK
RECEIVED BY:
REGISTER OF WILLS
GLENDA FARNER STRASBAUGH
REGISTER OF WILLS
.,,~L./......:J
~ BUREAU OF INDIVIDUAL TAXES
INHERITANCE TAX DIVISION
OEPT. 2:8'0601
HARRISBURG, PA 1712:8-0601
FRED H WEGE JR
WEGE ASSOCIATES
8150 DERRY ST STE B
HBG PA
CUT ALONG THIS LINE
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
"
NOTICE OF INHERITANCE TAX
APPRAISEMENT, ALLOWANCE OR DISALLOWANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
IEY-1547 EX AFP lDl-151
:: .
'-(...
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
" ,') :>:' L,COUNTY
ACN
03-17-2003
SHERK
04-15-2002
21 02-0423
CUMBERLAND
101
J
SANDRA
.!.at)
Amount Remitted
.1
Inn
~,~'-\
------------------------------------------------------------------------------------------------------------
~
MAKE CHECK PAYAB~E AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
RETAIN LOWER PORTION FOR YOUR RECORDS ~'
BUREAU OF INDIVIDUAL TAXES,
INHERITANCE TAX DIVISION
PO BOX 280601
HARRISBURG PA 17126-0601
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
INHERITANCE TAX
STATEMENT OF ACCOUNT
REV-1607 EX AFP (03-05)
FRED
WEGE
8150
HBG
H WEGE JR
ASSOCIATES
DERRY ST STE B
PA
DATE
ESTATE OF
DATE OF DEATH
FILE NUMBER
COUNTY
ACN
01-17-2006
SHERK
04-15-2002
21 02-0423
CUMBERLAND
101
SANDRA
J
Amount Rellitted
17111
MAKE CHECK PAYABLE AND REMIT PAYMENT TO:
REGISTER OF WILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17013
NOTE: To insure proper credit to your account, submit the upper portion of this forll with your tax paYllent.
CUT ALONG THIS LINE
-+
RETAIN LOWER PORTION FOR YOUR RECORDS
4-
REV-1607 EX AFP (03-05)
:IBBE INHERITANCE TAX STATEMENT OF ACCOUNT ...
ESTATE OF SHERK SANDRA J FILE NO.21 02-0423 ACN 101 DATE 01-17-2006
THIS STATEHENT IS PROVIDED TO ADVISE OF THE CURRENT STATUS OF THE STATED ACN IN THE NAHED ESTATE. SHOWN BELOW
IS A SUHHARY OF THE PRINCIPAL TAX DUE, APPLICATION OF ALL PAYHENTS, THE CURRENT BALANCE, AND, IF APPLICABLE,
A PROJECTED INTEREST FIGURE.
DATE OF LAST ASSESSMENT OR RECORD ADJUSTMENT: 03-17-2003
PRINCIPAL TAX DUE: 10,992.36
PAYMENTS (TAX CREDITS):
PAYMENT RECEIPT DISCOUNT (+) AMOUNT PAID
DATE NUMBER INTEREST/PEN PAID (-)
01-21-2003 CD002067 .00 10,992.36
01-05-2006 CD006178 9.04- 9.04
TOTAL TAX CREDIT 10,992.36
BALANCE OF TAX DUE .00
INTEREST AND PEN. .00
IF PAID AFTER THIS DATE, SEE REVERSE TOTAL DUE .00
If
SIDE FOR CALCULATION OF ADDITIONAL INTEREST.
( IF TOTAL DUE IS LESS THAN $1,
NO PAYHENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A "CREDIT" (CR),
YOU HAY BE DUE A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS. )
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